Fulminant Somatization: Medical Investigation in Trauma Survivors

Background: Somatic symptoms are common in trauma survivors, including those who have experienced sexual abuse. These symptoms sometimes continue or get worse during the course of medical investigations, provoking even more investigation, and leading to a vicious circle involving invasive medical procedures and frustrating attempts at diagnosis and care. In such cases, the symptoms may be considered fulminant. Method: This article presents a review and analysis of three cases of adolescents presenting with fulminant somatic symptoms. Results: In each case, the patient’s symptoms resolved when the focus of care shifted from investigation to support for coping. Sexual abuse history had been overlooked during the acute phase. Conclusions: In such patients, somatic investigation may evoke past trauma. Management should consider a shift in emphasis from investigation to promoting adaptation.